The Swiss Statement
The “Swiss Statement” was issued in January 2008 by the Swiss Federal Commission on AIDS Related Issues (an expert group of doctors and researchers). This group was concerned about the legal situation to HIV positive people in Switzerland and for serodifferent couples who wanted to have a baby.
They were worried about the accuracy of public and private information about the risk of HIV transmission for people on antiretroviral treatment.
One of the reasons that they issued the statement was to give doctors guidance to help serodifferent couples wishing to conceive a child. Many couples are unable or unwilling to use sperm washing or other methods of assisted reproduction and need to be able to make informed decisions about the level of risk involved with having sex when using antiretrovirals.
The statement described the transmission risk for someone on stable therapy as “negligible” and “similar to risks of daily life” It explains that, for example, even condom use is not 100% safe.
The statement makes it very clear that this description of someone at a very low risk of transmission only applies to someone who:
- Has an undetectable viral load for at least 6 months
- Has excellent adherence
- Has no other STIs.
The Swiss doctors calculated that conceiving naturally under these cirumstances would be unlikely to lead to HIV infection in the HIV negative partner. They were not recommending that condoms should now be abandoned forever – just that the risks during limited conception attempts were so small compared to the importance for many couples to have children.
They also stated that PEP treatment wouldn’t be given if a condom broke and the HIV positive partner fullfilled the above criteria.